Obstrucción intestinal secundaria a implantes endometriósicos

Zazil Botello Hernández, Antonio Corona Bautista, Raul Castillo, Edilberto Jiménez Rendón, Fernando de la Torre Rendón, Mercedes Andrea Cruz Salinas
In: Revista de especialidades m�dico-quir�rgicas · 2011 · vol. 16(4) , pp. 252–255 · W1490973325
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This case study describes a 25-year-old female patient who underwent hemicolectomy for ileal obstruction caused by endometriosis, highlighting endometriosis as a differential diagnosis for intestinal obstruction in young women with painful periods.

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Abstract

Intestinal obstruction is one of the most common disorders treated at the emergency department. It is a syndrome with multiple causes; one particularly interesting is the endometriosis, which occurs in up to 37% of patients with endometriosis. This paper reports the case of a 25 year-old female patient with a history of dysmenorrheal, who, in her menstrual period, went to emergence services with abdominal pain, nausea and lack of bowel movements. On palpation, were found pain in lower abdomen, signs of peritoneal irritation and adequate peristalsis. The laboratory tests showed neutrophilia without leukocytosis. Abdominal radiographs revealed fluid levels, dilated bowel loops, loop fixed and low gas in mesogastrium rectal ampulla. The ultrasound reported plastron small bowel and abundant free fluid. At laparotomy two rings were found at the distal ileum stenosing to 3 cm and 6 cm away from the ileocecal valve. We performed right hemicolectomy with ileotransverse anastomosis. Histopathologic study reported ileal stenosis secondary to endometriosis of the bowel wall. When patient improved was discharged and referred to Obstetrics and Gynecology services for monitoring. Clinical presentation is nonspecific and abdominopelvic endometriosis is associated to menstrual cycles up to 50% of patients. In young women, as this case, without previous surgeries and a history of painful periods and bloating associated to chronic constipation, endometriosis should be included in the differential diagnosis of intestinal obstruction.

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endometriosis

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